scotts-marina-at-lake-grapevine-ltd-dba-silver-lake-marina-just-for ( 2012 )


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  •                                  NO. 07-10-00277-CV
    IN THE COURT OF APPEALS
    FOR THE SEVENTH DISTRICT OF TEXAS
    AT AMARILLO
    PANEL A
    JANUARY 23, 2012
    SCOTT'S MARINA AT LAKE GRAPEVINE LTD., D/B/A
    SILVER LAKE MARINA, JUST FOR FUN OF NORTH
    TEXAS, INC. AND SILVER LAKE MARINA STORE, INC.,
    APPELLANTS
    v.
    ALLEN JOHNATHAN BROWN, APPELLEE
    FROM THE 342ND DISTRICT COURT OF TARRANT COUNTY;
    NO. 342-213092-05; HONORABLE BOB MCGRATH, JUDGE
    Before CAMPBELL and HANCOCK and PIRTLE, JJ.
    OPINION
    Appellants, Scott’s Marina at Lake Grapevine, Ltd. d/b/a Silverlake Marina
    (Scott’s Marina), Just for Fun of North Texas, Inc. (JFF), and Silver Lake Marina Store,
    Inc. (the Store), appeal a judgment entered in favor of appellee, Allen Johnathan Brown,
    that awarded Brown $676,300 for past and future actual damages, $10,667.80 for court
    costs, and post-judgment interest at a rate of five percent per annum. We affirm.
    Background
    Because the issues presented by appellants primarily challenge the sufficiency of
    the evidence, we will limit the background to a general overview of the factual
    background and procedural history of the case. We will discuss the evidence more fully
    in the analysis of each of appellants’ issues below.
    Brown was employed to work weekends at the Store during the summer of 2005.
    The Store was owned by Scott’s Marina, but had been leased to JFF. Brown was hired
    by JFF and was paid by JFF.
    On June 11, 2005, Brown was working the cash register at the Store when he
    heard a “whoosh-type” noise and was immediately struck by a “godawful smell.” A
    substance began to backup and overflow out of the hub drain1 of a Pepsi soda fountain
    machine in the Store. The Store was initially evacuated before Brown was ordered to
    clean up the backflowed substance. Brown performed the cleanup with the use of a
    mop and bucket. No additional protective wear was provided to Brown while he cleaned
    up the backflow. Additional spills occurred over the remainder of the weekend of the
    11th. It took Brown about ten to fifteen minutes to clean the spillages each time they
    occurred.
    The following weekend, the hub drain again backflowed on multiple occasions.
    On these instances, two other Store employees assisted Brown in clean up of the
    spillages.   Plumbers were called to the Store on June 20, and apparently installed
    1
    The hub drain of a soda fountain machine is the receptacle at the bottom of the
    machine that is designed to catch spillage from the machine.
    2
    backflow valves to the hub drain line. Regardless, no further backflows occurred after
    June 19.
    During the second weekend, Brown developed a cough and a sore throat. He
    indicated that the glands in his neck started to swell. Nonetheless, Brown attempted to
    work through his developing illness. However, due to severe vomiting and diarrhea,
    Brown eventually had to seek medical attention on July 5. Brown’s illness worsened
    from July 5 to July 11, when Brown had his mother take him to the emergency room
    because he was vomiting uncontrollably. Brown was hospitalized and diagnosed with
    enteroviral meningitis and Lemierre’s Syndrome.        To prevent the spread of these
    conditions, doctors tied off one of Brown’s jugular viens. Brown spent twelve days in
    the hospital due to this illness. After his release from the hospital, Brown continued to
    have medical and emotional problems that restricted his everyday life.
    Brown filed suit against the appellants contending that the spillage that he was
    required to clean up in the Store on the weekends of June 11th and 18th of 2005 was
    sewage containing human feces, and that this exposure to human feces caused
    Brown’s acute and continuing illnesses. At the trial, Brown offered the expert testimony
    of Itzhak Brook on the issue of causation.      Brook, a leading expert in the field of
    anaerobic infectious disease, opined that, in reasonable medical probability, Brown’s
    exposure to sewage containing human feces at the Store was the proximate cause of
    his enteroviral meningitis and Lemierre’s Syndrome. At the close of evidence, the case
    was submitted to the jury who returned a verdict in favor of Brown. Specifically, the jury
    found that appellants were negligent; that Scott’s Marina was 60 percent responsible,
    3
    JFF was 20 percent responsible, and the Store was 20 percent responsible; and
    awarded Brown damages of $250,000 for past physical pain and mental anguish,
    $75,000 for future physical pain and mental anguish, $89,000 for past lost earning
    capacity, $102,300 for future lost earning capacity, $60,000 for past medical expenses,
    and $100,000 for future medical expenses.         Appellants filed a motion for entry of
    judgment notwithstanding the verdict, which was denied by the trial court. The trial
    court entered judgment on the jury’s verdict, and appellants appealed this judgment.
    Scott’s Marina filed a brief on its own behalf and JFF and the Store filed a joint
    brief on their behalf. The issues presented by Scott’s Marina are (1) the trial court
    abused its discretion in admitting Brook’s unreliable testimony, (2) the evidence was
    insufficient to establish that Brown was exposed to sewage at the Store, and (3) the
    jury’s award of actual damages cannot be sustained. The issues presented by JFF and
    the Store are (1) the trial court erred in admitting Brook’s testimony over appellants’
    objection, (2) the evidence is insufficient to support the jury’s implied finding that Brown
    was exposed to human waste, and (3) the evidence is insufficient to support the jury’s
    implied finding that appellants should have foreseen the risk that Brown could be
    exposed to human waste. We will address appellants’ issues in a slightly different order
    starting with the issue of whether the evidence was sufficient to establish that Brown
    was exposed to human waste.
    Sufficiency of the Evidence – Exposure to Human Feces
    By both of their second issues, appellants contend that the evidence was
    insufficient to support the jury’s implied finding that Brown was exposed to sewage
    4
    containing human feces by cleaning up the backflowed spillage in the Store on the
    weekends of June 11 and 18 of 2005. The significance of this implied finding is that
    Brook’s expert causation testimony assumes that Brown was exposed to human feces
    containing enterovirus, and that this exposure led to Brown’s subsequent medical
    problems.    Additionally, JFF and the Store contend, by their third issue, that the
    evidence was insufficient to support the foreseeability of human feces backflowing into
    the Store.
    Standard of Review
    When a party challenges the legal sufficiency of the evidence supporting a jury
    finding, we consider the evidence in the light most favorable to the finding and indulge
    every reasonable inference that supports it. See City of Keller v. Wilson, 
    168 S.W.3d 802
    , 822 (Tex. 2005). We credit favorable evidence if a reasonable jury could and
    disregard contrary evidence unless a reasonable jury could not. 
    Id. at 827.
    If the
    evidence would permit reasonable and fair-minded people to reach the finding under
    review, the legal sufficiency challenge fails. 
    Id. When a
    party challenges the factual sufficiency of the evidence, we consider all
    of the evidence and will set aside the finding only if the evidence supporting the finding
    is so weak or so against the overwhelming weight of the evidence that the finding is
    clearly wrong and unjust.       Cain v. Bain, 
    709 S.W.2d 175
    , 176 (Tex. 1986).           In
    conducting our review, we are mindful that the jury is the sole judge of the credibility of
    the witnesses and the weight to be given their testimony. City of 
    Keller, 168 S.W.3d at 819
    ; Hinkle v. Hinkle, 
    223 S.W.3d 773
    , 782 (Tex.App.—Dallas 2007, no pet.).
    5
    Analysis
    Appellants contend that the overwhelming weight of the evidence proves that the
    configuration of the plumbing was such that it would not have been possible for
    wastewater or sewage containing human waste to have backflowed into the Store on
    the occasions in issue. Due to the configuration of the plumbing, appellants argue that
    the evidence conclusively establishes that the substance that backflowed into the Store
    came from the burger dock sink and, therefore, did not contain feces.
    Appellants contend that the evidence conclusively established that the drain line
    from the Store was not directly connected to a sewage line that was used to evacuate
    the sewage from boats.     Brown contends that there was significant conflict in the
    evidence that would allow the jury to reasonably conclude that appellants altered the
    configuration of the drainage system between the time of the spillages in question and
    subsequent inspections of that drainage system.      In fact, at the conclusion of the
    hearing on appellants’ motion for judgment notwithstanding the verdict, the trial court
    stated, “The findings of the jury can only be understood if you believe the defendants
    changed the configuration of the pipes after the incidents, and then came to court and
    lied about it. There is testimony to support this. There’s no evidence to refute it.”
    Further, it is undisputed that the hub drain line was connected to the gray water burger
    dock line and that backflow prevention devices were not installed on these lines. While
    we conclude that there is some evidence that would “refute” the theory that appellants
    altered the configuration of the drainage system and then lied about it, we agree with
    the trial court that there is some evidence to support this conclusion. As such, we must
    6
    defer to the jury’s reasonable resolution of this conflict in the evidence. See City of
    
    Keller, 168 S.W.3d at 819
    .     Thus, we conclude that the evidence was sufficient to
    establish that the pump-out sewage line was connected to the hub drain line.
    However, concluding that the pump-out sewage line was connected to the hub
    drain line is not sufficient to establish that the spillage was sewage containing human
    feces. Appellants contend that the configuration of the pump-out sewage system was
    such that, at the time of the spillage, it would have been impossible for sewage from the
    pump-out sewage line to have backflowed into the Store. According to appellants, this
    is because the two pump-outs operated in conjunction with one another based on
    vacuum suction at the time of the spillage and the multiple openings in the hub drain
    line and gray water burger dock line would have prevented the pump-outs from being
    able to push the sewage up through the hub drain line. Brown’s ultimate theory is that
    appellants installed a second motor on the pump-out sewage line in the Spring of 2005
    that allowed the pump-out lines to operate independently of one another, and that this
    motor provided the force sufficient to push the sewage through the hub drain line.
    The evidence relating to whether the pump-outs operated independently or in
    conjunction at the time of the backflow is in sharp conflict. Evidence that supports the
    determination that the pump-outs were working independently and on their own motors
    in June of 2005 was presented through the testimony of Rulene Reynolds, manager of
    Silver Lake Marina at the time of the incidents, J.B. Strohkirch, maintenance man for the
    marina, and Tom Sanford, superintendent for the marina.        However, each of these
    witnesses also provided testimony that, at the time of the incidents, the pump-out lines
    7
    were working in conjunction with one another, with only one motor, based on vacuum
    suction.2 Because this testimony is internally inconsistent, we must defer to the jury’s
    determination of which version of events was credible. See id.; 
    Hinkle, 223 S.W.3d at 782
    . The jury’s resolution of this conflict is especially entitled to deference in light of the
    evidence addressed above that would allow a reasonable determination that appellants
    altered the configuration of the plumbing and “then came to court and lied about it.”
    Further bolstering the jury’s determination that the pump-outs pushed sewage
    into the Store is the testimony providing that the pump-outs could only operate using
    vacuum suction if they were not connected to the hub drain line. In other words, the
    evidence established that it would not be possible for the pump-outs to be connected to
    the hub drain line and still operate in conjunction, using only a single motor, because
    the openings at the end of the hub drain line would have prevented the creation of a
    vacuum. However, if the pump-outs operated independently, with each having their
    own motor, the pump-outs would have been able to operate even if connected to the
    hub drain line. In fact, according to Mark Jensen, appellants’ engineering expert, the
    motor would allow the waste from the pump-outs to be pushed through the hub drain
    line causing the backflow of waste containing human feces into the Store.
    In addition, a review of the entire record reveals that there was significant
    disagreement among the eyewitnesses about the characteristics of the substance that
    backflowed into the Store. Some of the witnesses testified that the substance was clear
    2
    Both Strohkirch and Sanford testified that a second motor was installed in
    March of 2005 in their pre-trial depositions. However, at trial, each changed their
    testimony to indicate that the second motor was installed in the Fall of 2005.
    8
    and smelled like rotten food and grease.         Other eyewitnesses testified that the
    substance was dirty and that it smelled like sewage. Obviously, this testimony creates a
    conflict in the evidence regarding the characteristics of the substance that backflowed
    into the Store. The jury clearly resolved this conflict by determining that the substance
    that backflowed into the Store was sewage containing human feces. Because there is
    evidence to support the jury’s implied finding that the substance that backflowed into the
    Store contained human feces, we must conclude that there was legally and factually
    sufficient evidence to support this implied finding. See Walker & Assocs. Surveying,
    Inc. v. Austin, 
    301 S.W.3d 909
    , 916-17 (Tex.App.—Texarkana 2009, no pet.).
    As the evidence is sufficient for the jury to have concluded that the substance
    that backflowed into the Store was sewage containing human feces, regardless of JFF
    and the Store’s knowledge of the configuration of the plumbing, it was foreseeable that
    making an employee clean up sewage containing human feces by use of a mop and
    bucket could expose the employee to viruses contained within the human feces. The
    combined effect of the evidence that allows for a reasonable inference that JFF and the
    Store were aware of the plumbing’s configuration together with JFF and the Store
    requiring Brown to clean up a backflowed spillage that the jury could reasonably find to
    have been sewage containing human feces is enough to establish that Brown’s
    exposure to human feces was foreseeable.
    Consequently, we overrule appellants’ second issues and conclude that the
    evidence was sufficient to support the jury’s implied finding that the substance that
    backflowed into the Store was sewage containing human feces. Likewise, due to the
    9
    the evidence allowing the jury to reasonably conclude that JFF and the Store were
    aware of the plumbing’s configuration and that Brown was required to clean up human
    feces by JFF and the Store, the evidence is sufficient to support the jury’s implied
    finding that Brown’s injury was foreseeable. As such, we also overrule JFF and the
    Store’s third issue.
    Admissibility of Expert Causation Testimony
    By their first issues, appellants contend that the trial court erred in admitting the
    expert medical testimony on causation of Dr. Brook over appellants’ objections that the
    testimony was unreliable. While their issue is presented in terms of admissibility, a
    review of the arguments of appellants reveal that appellants are actually contending that
    the evidence is insufficient to establish the reliability of Brook’s expert testimony on
    causation.   As such, our analysis of the sufficiency of the evidence supporting the
    reliability of Brook’s testimony will determine our assessment of the admissibility of
    Brook’s testimony. See Merrill Dow Pharms., Inc. v. Havner, 
    953 S.W.2d 706
    , 711
    (Tex. 1996) (evidence must be scientifically reliable to constitute “some evidence” to
    support judgment).
    Standard of Review
    For expert testimony to be admissible, the expert must be qualified, the testimony
    must be relevant to the issues in the case, and the testimony must be based on a
    reliable foundation. TXI Transp. Co. v. Hughes, 
    306 S.W.3d 230
    , 234 (Tex. 2010);
    Gross v. Burt, 
    149 S.W.3d 213
    , 237 (Tex.App.—Fort Worth 2004, pet. denied). Even
    when expert testimony is admitted by the trial court, a party may complain on appeal
    10
    that the expert testimony is legally insufficient to support the judgment because it is
    unreliable so long as that party objected to the reliability of the evidence before or
    during trial.3 Maritime Overseas 
    Corp., 971 S.W.2d at 409
    ; 
    Gross, 149 S.W.3d at 237
    .
    Unreliable expert testimony is not relevant evidence and, therefore, constitutes no
    evidence. See TXI Transp. 
    Co., 306 S.W.3d at 234
    ; 
    Gross, 149 S.W.3d at 237
    .
    In determining whether expert testimony is reliable, a reviewing court must
    employ “an almost de novo-like review and, like the trial court, look beyond the expert’s
    bare testimony to determine the reliability of the theory underlying it.       
    Gross, 149 S.W.3d at 237
    (quoting Austin v. Kerr-McGee Refining Corp., 
    25 S.W.3d 280
    , 285
    (Tex.App.—Texarkana 2000, no pet.)). “An expert’s simple ipse dixit is insufficient to
    establish a matter; rather, the expert must explain the basis of his statements to link his
    conclusions to the facts.”    Earle v. Ratliff, 
    998 S.W.2d 882
    , 890 (Tex. 1999).          In
    assessing the admissibility of expert testimony, we do not focus on the correctness of
    the expert’s opinion, but on the reliability of the analysis the expert used in reaching his
    or her conclusions. 
    Gross, 149 S.W.3d at 237
    .
    3
    We acknowledge that Brown contends that appellants waived their issue
    regarding the reliability of Brook’s expert testimony. However, when the video of
    Brook’s deposition testimony was offered at trial, the appellants timely objected to this
    evidence “based on the hearing that we’ve had outside the presence of the jury with
    regard to Daubert and those matters.” The trial court overruled the objection and the
    videotaped deposition was shown to the jury. As such, appellants’ objection to the
    admission of Brook’s testimony at trial simply re-urged their objections made pretrial,
    and were sufficient to preserve error. See TEX. R. APP. P. 33.1.
    Further, appellants can challenge the sufficiency of the evidence supporting the
    reliability of Brook’s testimony so long as they objected to the reliability of the evidence
    before trial or when it is offered at trial. See Maritime Overseas Corp. v. Ellis, 
    971 S.W.2d 402
    , 409 (Tex. 1998). Appellants, in the present case, objected to the reliability
    of Brook’s testimony both before trial and when offered at trial.
    11
    The Texas Supreme Court has articulated six nonexclusive factors appellate
    courts should consider in determining whether scientific testimony is reliable:
    (1)    The extent to which the theory has been or can be tested;
    (2)    The extent to which the technique relies upon subjective
    interpretation of the expert;
    (3)    Whether the theory has been subjected to peer review and
    publication;
    (4)    The technique’s potential rate of error;
    (5)    Whether the underlying theory or technique has been generally
    accepted as valid by the relevant scientific community; and
    (6)    The non-judicial uses that have been made of the theory or
    technique.
    
    Havner 953 S.W.2d at 714
    . However, the approach to assessing reliability must be
    flexible depending on the nature of the evidence. Transcon. Ins. Co. v. Crump, 
    330 S.W.3d 211
    , 216 (Tex. 2010).       One additional factor that has been held to be of
    particular significance is whether the expert has ruled out other likely causes within a
    reasonable degree of medical probability. See 
    id. at 217-18.
    Analysis
    a. The Extent to Which the Theory Has Been or Can Be Tested
    Appellants’ challenge of the testing of Brook’s theory basically challenges the
    theory in two particular aspects: (1) Brook assumed that Brown was exposed to
    wastewater or sewage containing human feces, and (2) Brook failed to establish an
    accepted causal link between exposure to human feces and development of Lemierre’s
    Syndrome.
    12
    As for Brook’s assumption that Brown was exposed to human feces, his
    testimony is clear that his opinion is premised on this assumption. Thus, the weight that
    the jury could reasonably afford Brook’s opinion was dependent on the jury’s resolution
    of the factual issue regarding whether Brown was exposed to human feces when he
    cleaned up the backflowed spillage at the Store.        As addressed above, there was
    sufficient evidence presented to allow the jury to reasonably conclude that the
    backflowed spillage contained human feces. However, because Brook acknowledged
    this assumption and because the validity of this assumption relied on the jury’s
    determination of fact, the validity of Brook’s assumption goes to the weight to be
    ascribed to the evidence rather than to its admissibility. See LMC Complete Auto., Inc.
    v. Burke, 
    229 S.W.3d 469
    , 478 (Tex.App.—Houston [1st Dist.] 2007, pet. denied) (“The
    weakness of facts in support of an expert’s opinion generally goes to the weight of the
    testimony rather than the admissibility.”).
    As for the causal connection between exposure to human feces and Lemierre’s
    Syndrome, we believe that there was sufficient evidence presented during the pre-trial
    hearing to establish that a causal chain between exposure to human feces and
    Lemierre’s Syndrome is accepted. Dr. Louis Marshall Sloan, appellants’ expert witness,
    testified in his deposition that the primary cause of enteroviral infection is exposure to
    fecal matter.   Sloan also acknowledged the textbook, PRINCIPLES         AND   PRACTICE   OF
    INFECTIOUS DISEASES, to be commonly relied upon as authoritative by infectious disease
    specialists. Portions of this textbook offered by Brown in his pre-trial evidence identifies
    that wastewater and sewage are common sources of enteroviral infections.              While
    Sloan and Brook disagreed regarding whether the enterovirus or fusobacterium caused
    13
    Brown’s pharyngitis that led to the Lemierre’s Syndrome, Brown offered a peer reviewed
    article as well as citation to the authoritative textbook that Lemierre’s Syndrome is an
    uncommon, but known, result of a viral pharyngitis. After reviewing all of the evidence
    that was offered to establish that Brown’s exposure to human feces caused his
    enteroviral infection which led to his Lemierre’s Syndrome, while certainly not
    conclusive, we believe that there is some medical acceptance of a causal connection
    between exposure to human feces and Lemierre’s Syndrome that is sufficient to
    establish the reliability of Brook’s theory.
    b. The Extent to Which the Theory Has Been Subjected to Peer Review and
    Publication
    Appellants next challenge the lack of peer review or publication of Brook’s theory.
    Essentially, appellants complain that Brook did not prove that Brown was exposed to
    human feces that contained enterovirus, and that he did not cite any published support
    for a scientifically significant link between enteroviral and/or fuseobacteria exposure and
    the types of illnesses which Brown suffered.
    As addressed above, Brook premised his testimony on the clearly stated
    assumption that Brown was exposed to sewage containing human feces when Brown
    cleaned up the backflowed spillage in the Store. Both Brook and Sloan as well as much
    of the published medical articles that were submitted by Brown acknowledge that
    enterovirus can be found in human feces, and that the most common form of
    transmission of enteroviral infections is oral-fecal transmission.
    14
    As to the claimed lack of published support for a link between enteroviral
    infection and Brown’s medical issues, the published articles appear to support Brook’s
    explanation of the link between the enteroviral infection causing the pharyngitis, which
    then created the conditions necessary for Brown to develop Lemierre’s Syndrome.
    Sloan opined that Brown’s Lemierre’s Syndrome was caused by fusobacterium alone.
    However, fusobacterium is a natural bacteria that is in the mouths of all humans. This
    fusobacterium is prevented from causing infections by the body’s natural immune
    system. According to Brook and the medical articles offered by Brown, when a virus
    weakens a person’s immune system, it can create conditions where the fusobactrium
    can be released and can cause pharyngitis. Thus, while the experts disagree regarding
    whether the enterovirus or the fusobacterium caused Brown to develop the pharyngitis
    that became Lemierre’s Syndrome, there is published support for a scientifically
    significant link between Brown’s exposure to human feces and his development of
    Lemierre’s Syndrome.
    c. The Extent to Which Other Likely Causes Were Ruled Out
    Appellants next contend that Brook’s expert testimony on causation was
    unreliable because he failed to rule out other likely causes of Brown’s illness. This is an
    important factor in assessing the reliability of an expert’s opinion testimony.       See
    Transcon. Ins. 
    Co., 330 S.W.3d at 217-18
    ; 
    Havner, 953 S.W.2d at 720
    .
    Both experts in this case opined that the most common source of enteroviral
    infection is the oral introduction of human fecal matter. Brook testified that the sewage
    that backflowed into the Store was, within a reasonable degree of medical probability,
    15
    the source of Brown’s enteroviral infection.    Sloan testified that, if the backflowed
    spillage was sewage and if the incubation period matched, then it was a “higher
    possibility” as the source of Brown’s enteroviral infection. Further, many other likely
    causes of enteroviral infection were considered and ruled out both by Brook as well as
    by the physicians that treated Brown at Baylor Regional Medical Center at Grapevine.
    Finally, Brown provided an affidavit that attested that he was not exposed to any of the
    other most common sources of enterovirus.
    In the final analysis, Brook was able to rule out the most likely other causes of
    Brown’s contracting the enteroviral infection.4 A medical causation expert need not
    disprove or discredit every possible cause other than the one he espouses. Transcon.
    Ins. 
    Co., 330 S.W.3d at 218
    . If evidence presents other plausible causes that could be
    negated but are not, the reliability of the testimony is undermined. See 
    id. However, in
    this case, the only plausible causes that were capable of being negated were negated.
    d. Incubation Period and Brown’s Illness
    Another challenge to Brook’s reliability raised by appellants is that the period
    between Brown’s exposure to the spillage and his development of symptoms does not
    correlate to the medically accepted incubation period for enterovirus.             Sloan
    emphasized this alleged inconsistency in Brook’s testimony.
    4
    We disagree with the dissent’s characterization of Brook’s testimony that he was
    able to rule out other possible sources of Brown’s contraction of enterovirus as
    conclusory. A number of other possible sources of Brown’s exposure to enterovirus
    were ruled out by information Brown provided to the doctors that treated his enteroviral
    infection, and this information was documented in Brown’s medical records which were
    reviewed by Brook. Further, Brown’s affidavit provided additional evidence ruling out
    his exposure to other sources of enterovirus.
    16
    Sloan indicated that the normal incubation period for an enteroviral infection is
    three to five days with the extremes being two to twelve days.5 Because Brown did not
    seek medical care until July 4, which was fifteen days after his last exposure to the
    backflowed spillage in the Store, Sloan concluded that the exposure could not have
    caused Brown’s enteroviral infection. However, Brown’s mother indicated to Brown’s
    initial treating physicians that the onset of his symptoms actually occurred on or about
    June 20. Clearly, symptoms appearing on June 20, the day after Brown’s last exposure
    to the spillage, would fit within the incubation period of both Brook and Sloan. Nothing
    in the testimony of Sloan acknowledges this June 20 onset of symptoms.
    As there is evidence that supports Brown’s onset of symptoms occurring on June
    20, well within the incubation periods identified by both experts, we do not conclude that
    the delay in Brown exhibiting symptoms is evidence that Brook’s expert opinion is
    unreliable.
    Conclusion
    As our review of the record reveals that the evidence was sufficient to support
    the reliability of Brook’s expert testimony opining that Brown’s exposure to human feces
    at the Store caused his enteroviral infection6 which then led to Brown’s other medical
    conditions, we overrule appellants’ first issues.
    5
    Brook’s identification of the incubation period for enteroviral infection was that
    the typical case would become symptomatic between twelve hours to three days with
    the outer extreme being symptoms appearing fourteen days after exposure.
    6
    The dissent focuses on the legal sufficiency of the evidence supporting whether
    the sewage containing human feces that backflowed into the Store contained
    17
    Sufficiency of the Evidence – Damages
    By Scott’s Marina’s third issue, appellants challenge the sufficiency of the
    evidence to support the jury’s award of actual damages to Brown.7           Specifically,
    appellants claim that the jury’s award of damages was excessive.
    As a general principle, we need to remain mindful that the amount of damages
    awarded is uniquely within the jury’s discretion. Missouri Pac. R.R. Co. v. Roberson, 
    25 S.W.3d 251
    , 257 (Tex.App.—Beaumont 2000, no pet.). “[I]t is only when [a jury’s]
    enterovirus, and whether Brown’s cleaning of this sewage was how Brown contracted
    the enteroviral infection. While we agree with the dissent’s analysis that there were
    ways in which Brown’s evidence that the sewage contained enterovirus could have
    been stronger, we disagree with the dissent’s conclusion that the evidence establishing
    the likely presence of enterovirus in the sewage containing human feces was legally
    insufficient.
    The evidence that supports the conclusion that the sewage that backflowed into
    the Store contained enterovirus and that it was the source of Brown’s contraction of the
    enteroviral infection includes: Brook’s testimony that, within a reasonable degree of
    medical probability, the most likely source of Brown’s enteroviral infection was the
    sewage containing human feces that backflowed into the Store; Sloan’s testimony that,
    if Brown was exposed to human feces by cleaning up the backflowed substance and his
    onset of symptoms fell within the incubation period, facts which are established by
    sufficient evidence, then the spillage was the “higher possibility” as the source of
    Brook’s enteroviral infection; and the recognition in the authoritative textbook,
    PRINCIPLES AND PRACTICE OF INFECTIOUS DISEASES, of the increased risk of enteroviral
    infection arising from exposure to human feces.
    Likewise, as discussed in footnote 4, we conclude that there is substantial
    evidence ruling out other sources of enterovirus, and disagree with the dissent’s
    characterization that other sources were ruled out solely on the basis of Brook’s bare
    conclusion.
    7
    While the issue of the sufficiency of the evidence to support the damages
    awarded is raised only by Scott’s Marina, under the authority of Texas Rule of Appellate
    Procedure 9.7, JFF and the Store joined in and adopted by reference all issues and
    arguments advanced by Scott’s Marina. See TEX. R. APP. P. 9.7. Thus, we will
    consider the issue of the sufficiency of the evidence to support the damages awarded
    as being asserted by all appellants.
    18
    award of damages is ‘flagrantly outrageous, extravagant, and so excessive as to shock
    the judicial conscience,’ that it may be disturbed.” 
    Id. at 257-58
    (quoting Am. Bank of
    Waco v. Waco Airmotive, Inc., 
    818 S.W.2d 163
    , 175 (Tex.App.—Waco 1991, writ
    denied)).
    The standard of review for a challenge contending that an award of actual
    damages was excessive is the same as is used in a factual sufficiency challenge. See
    Maritime Overseas 
    Corp., 971 S.W.2d at 406
    .            As stated above, when a party
    challenges the factual sufficiency of the evidence, we consider all of the evidence and
    will set aside the finding only if the evidence supporting the finding is so weak or so
    against the overwhelming weight of the evidence that the finding is clearly wrong and
    manifestly unjust. 
    Cain, 709 S.W.2d at 176
    . However, we must remain mindful that the
    jury is the sole judge of the credibility of the witnesses and the weight to be given their
    testimony. City of 
    Keller, 168 S.W.3d at 819
    ; 
    Hinkle, 223 S.W.3d at 782
    .
    Appellants specifically challenge the following damages findings: (1) $89,000 for
    loss of past wages, (2) $102,300 for loss of earning capacity in the future, (3) $60,000
    for medical expenses incurred before trial, (4) $100,000 for future medical expenses, (5)
    $250,000 for past physical pain and mental anguish, and (6) $75,000 for future physical
    pain and mental anguish.
    Lost Earning Capacity
    Appellants’ first challenge to the jury’s award of damages goes to the sufficiency
    of the evidence to support the awards for Brown’s lost earning capacity. Lost wages
    refers to the actual loss of income due to an inability to perform a specific job from the
    19
    time of injury to the time of trial.    Koko Motel, Inc. v. Mayo, 
    91 S.W.3d 41
    , 51
    (Tex.App.—Amarillo 2002, pet. denied). On the other hand, lost earning capacity is an
    assessment of what the plaintiff’s capacity to earn a livelihood actually was and the
    extent to which that capacity was impaired by the injury. 
    Id. Both forms
    of lost earning
    capacity are measured not by what a person actually earned before an injury, but by
    what the person’s capacity to earn was even if he had never worked in that capacity in
    the past. Gen. Motors Corp. v. Burry, 
    203 S.W.3d 514
    , 553 (Tex.App.—Fort Worth
    2006, pet. denied).    Because calculating the extent of impairment constitutes an
    exercise in uncertainty, the assessment of past capacity is left to the discretion of the
    jury so long as there is reasonably certain evidence to support the jury’s exercise of that
    discretion. Koko Motel, 
    Inc., 91 S.W.3d at 51-52
    .
    Looking to the evidence in support of the jury’s award of $89,000 for Brown’s lost
    earning capacity between injury and trial, the jury was presented evidence that Brown
    was a hard working young man that held two jobs before the injury. The jury also heard
    that Brown was a fairly skilled automobile mechanic, and that he was attempting to
    become more skilled in this area through working at an auto repair and performance
    garage, where he earned approximately $10 per hour, and through pursuing an
    education in marketing and management in the automotive aftermarket industry. As a
    side business, Brown ran an automobile repair service out of his house, charging other
    students $20 per hour to perform various repairs to their vehicles. Further, the jury
    heard evidence that Brown was unable to maintain employment because of the
    frequency with which he continued to have illnesses and setbacks due to his exposure
    to human feces at the Store.
    20
    Thus, we conclude that the evidence was sufficient to establish that, prior to the
    injury, Brown had the capacity to work, at least, a 40-hour work week, and the evidence
    of the skills Brown possessed in automobile repair is sufficient to establish a reasonable
    inference that he would have had the capacity to work in the auto repair industry, and
    that he would have earned at least $10 per hour. See 
    Burry, 203 S.W.3d at 553
    . Also,
    we conclude that the evidence was sufficient to establish that Brown’s inability to work
    was the result of the illnesses and their effects caused by his exposure to human feces
    at the Store. As a result, we conclude that, at a minimum, Brown’s lost capacity to earn
    wages from the time of his exposure to human feces at the Store to the trial was
    approximately $94,000.8 While an offset for wages that Brown was able to earn during
    this time would bring the total slightly under the damages awarded by the jury, we note
    that our calculation of lost earnings reflects a minimum calculation of lost earnings
    supported by the record, and we cannot say that the jury abused its discretion by
    awarding Brown slightly more than the absolute minimum amount that the evidence
    would support. See Koko Motel, 
    Inc., 91 S.W.3d at 51-52
    .
    Turning to appellants’ challenge of the sufficiency of the evidence to support the
    jury’s award of $102,300 for future lost earning capacity, the jury heard evidence that
    Brown was unable to hold steady employment due to the frequency with which he
    became ill and needed medical attention. After repeated attempts, Brown has been
    unable to progress toward a college degree due to the physical and psychological
    effects of his exposure to human feces at the Store. The jury also heard evidence that,
    because of seizures Brown began to experience after the instant incident, he is unable
    8
    This calculation is based on a $10 per hour job working 40 hours per week.
    21
    to drive safely. Finally, the jury also heard evidence that Brown suffered from post-
    traumatic stress disorder and depression, and that his treating psychologist felt that
    Brown’s chances of recovery from these issues was guarded or pessimistic.
    Thus, we conclude that the evidence was sufficient to allow the jury to conclude
    that Brown’s future earning capacity was diminished by the illnesses he developed as a
    result of his exposure to human feces in the Store. The jury was able to infer that
    Brown would have a substantial life expectancy based on his health and vitality prior to
    the present incident, as well as the fact that he was only 23 years old at the time of trial.
    See Borden, Inc. v. Guerra, 
    860 S.W.2d 515
    , 524-25 (Tex.App.—Corpus Christi 1993,
    writ dism’d by agr.). We further conclude that it is reasonable for the jury to infer that
    Brown’s earning capacity is diminished by his inability to progress toward obtaining a
    higher education or to maintain steady employment, and that these limitations on
    Brown’s capacity are the direct result of his continuing illnesses and psychological
    problems which are the direct result of his exposure to human feces in the Store. The
    evidence of Brown’s inability to continue to advance within the automotive repair and
    performance field due to his injuries and their effects support a loss of earning capacity
    continuing into the future and resulting from Brown’s exposure to human feces at the
    Store. We conclude that the evidence was sufficient to allow the jury, in the exercise of
    its sound discretion, to determine the proper amount of damages to compensate Brown
    for future loss of earning capacity. See McIver v. Gloria, 
    140 Tex. 566
    , 
    169 S.W.2d 710
    , 712-13 (1943).
    22
    Medical Expenses
    Turning to appellants’ challenge to the sufficiency of the evidence to support the
    jury’s award of $60,000 for Brown’s past medical expenses, we note that appellants’
    entire argument is premised on their contention that the evidence is insufficient to
    establish a causal connection between Brown’s exposure to human feces in the Store
    and his resulting illness. However, as thoroughly addressed in the issues above, we
    have concluded that the evidence was sufficient to allow the jury to conclude that Brown
    was exposed to human feces and that this exposure was the producing cause of
    Brown’s past medical expenses. As such, we affirm the jury’s award of $60,000 for
    medical expenses incurred by Brown in the past.9
    Appellants also challenge the sufficiency of the evidence supporting the jury’s
    award of $100,000 for medical expenses reasonably expected to be incurred by Brown
    in the future. For future medical expenses to be recoverable, the evidence must show
    that there is a reasonable probability that such expenses will be incurred in the future.
    Columbia Med. Ctr. of Las Colinas v. Bush, 
    122 S.W.3d 835
    , 862-63 (Tex.App.—Fort
    Worth 2003, pet. denied). Due to the inherently speculative nature of awards for future
    medical expenses, the factfinder may award future medical damages based on the
    nature of the injury, the medical care rendered prior to trial, and the condition of the
    injured party at the time of trial. Ibrahim v. Young, 
    253 S.W.3d 790
    , 809 (Tex.App.—
    Eastland 2008, pet. denied).
    9
    We note that appellants do not challenge the sufficiency of the evidence to
    support the $60,000 amount of past medical expenses. As such, we may not review
    that issue. See Allright, Inc. v. Pearson, 
    735 S.W.2d 240
    , 240 (Tex. 1987).
    23
    In the present case, we conclude that the evidence is sufficient to establish a
    reasonable probability that Brown will sustain future medical expenses in treatment of
    the illnesses and effects arising from his exposure to human feces in the Store. Brook
    testified that the illnesses and even the treatments received by Brown would result in
    him having an increased susceptibility to infection, and this susceptibility has been
    borne out by the frequency with which Brown has had to seek medical care from the
    time of exposure to trial. Further, Dr. Rider, Brown’s treating psychologist, testified that
    Brown suffers from depression and post-traumatic stress disorder due to his exposure
    to human feces and illnesses arising therefrom, and that Brown’s prognosis is guarded
    or pessimistic. In addition, the jury heard evidence regarding the extent of medical
    treatment Brown received in the past, including significant treatments continuing years
    beyond Brown’s exposure. Based upon the evidence supporting the serious nature of
    Brown’s injuries, the cost and amount of medical care necessitated before trial, and the
    evidence of the reasonable probability that Brown will require frequent physical and
    psychological treatment in the future due to his exposure to human feces in the Store,
    we conclude that the jury’s exercise of its discretion in awarding Brown $100,000 for
    future medical expenses is supported by sufficient evidence. See 
    id. Physical Pain
    and Mental Anguish
    Finally, appellants challenge the sufficiency of the evidence to support the jury’s
    award of damages to Brown for physical pain and mental anguish.
    In addressing both the jury’s award of $250,000 for past physical pain and mental
    anguish and $75,000 for future physical pain and mental anguish, appellants’
    24
    arguments are confined solely to the sufficiency of the evidence to support the jury’s
    award for mental anguish damages. None of the appellants challenged the trial court’s
    charge to the jury which asked for a lump sum for both physical pain and mental
    anguish damages. Appellants did not draw the trial court’s attention to their complaint
    that there was insufficient evidence to support an award of mental anguish damages,
    separate and apart from physical pain damages, during the charge conference, in
    closing arguments, or in a motion for new trial. See Ake v. Monroe, No. 04-05-00751-
    CV, 2006 Tex.App. LEXIS 9138, at *11-12 (Tex.App.—San Antonio Oct. 25, 2006, no
    pet.) (mem. op.). As such, appellants are limited to challenging the sufficiency of the
    evidence supporting the damage award as a whole.           
    Id. at *12
    (citing Thomas v.
    Oldham, 
    895 S.W.2d 352
    , 359-60 (Tex. 1995), and Tagle v. Galvan, 
    155 S.W.3d 510
    ,
    514-16 (Tex.App.—San Antonio 2004, no pet.)). Because appellants do not argue that
    the evidence is insufficient to support the jury’s awards for physical pain and mental
    anguish, we are unable to assess the sufficiency challenge asserted by appellants.10
    See 
    id. at *13.
    Conclusion
    Having overruled each of appellants’ issues, we affirm the judgment of the trial
    court.
    Mackey K. Hancock
    Campbell, J., dissenting.                                   Justice
    10
    Even were we to conclude that the evidence is insufficient to support any
    award of damages to Brown for past or future mental anguish, it is possible that the
    jury’s entire awards of past and future physical pain and mental anguish damages were
    to compensate Brown for the physical pain he has and will suffer.
    25